Mentoring Needs Questionnaire

Mentoring Needs Questionnaire
Your Name

First NameLast Name
Your Hobbies and Interests

Other
What Best Describes you

Other
Have you had mentoring before?
Areas where you hope your mentor to make impact

Other
The role you would like your Mentor would take part

Other
Your Preference of Communication with your Mentor

Other
Your Preferred Mentor
Where do you hope to be in five years?
What do you hope to gain from this relationship?
Are there any ground rules you would like to set (e.g., confidentiality, openness, candor)?
Are any topics off limits?
What do you think will be challenging about this relationship?
What criteria would you like to use to evaluate the success of the relationship?
Any additional remarks or questions from your side
Should be Empty: